The association between pain characteristics and frailty risk is uncertain. to investigate the separate impact of the frequency, intensity and location of pain on frailty risk and its possible mechanisms. prospective cohort of 1505 individuals ≥63 years followed between 2012 and 2015 in Spain. In 2012, pain was classified into: lowest pain (Score 0), middle pain (Score 1-4) and highest pain (Score 5-6). Incident frailty was assessed in 2015 as having ≥3 Fried criteria or a Frailty Index (FI) ≥0.30. in multivariate analyses, the risk of frailty (measured with the Fried criteria or the FI) increased progressively with the frequency of pain, its intensity and the number of pain locations. Compared with those having the lowest pain score, the odds ratio (95% confidence interval) of Fried-based frailty was 1.24 (0.56-2.75) in the middle score and 2.39 (1.34-4.27; P-trend <0.01) in the highest score. Corresponding values for frailty as FI ≥0.30 were 1.39 (0.80-2.42) and 2.77 (1.81-4.24; P-trend <0.01). Odds ratios did not change after adjustment for alcohol intake, Mediterranean diet adherence or sedentary time, but were reduced with adjustment for pain-associated chronic diseases (cardiovascular disease, diabetes, chronic lung disease, osteomuscular disease and depression). A higher pain score was linked to higher risk of exhaustion and low physical activity (two out of five Fried criteria) and to a worse score in all FI domains. frequency, intensity and location of pain were associated with higher risk of frailty. Study associations were partly explained by pain-associated morbidity.

Background: There is unclear evidence that chronic pain may increase the risk of cardiovascular disease (CVD) incidence and mortality. This work evaluated the association between chronic pain, incidence of CVD, and changes in CVD risk factors. Methods: Cohort of 1091 community-dwelling individuals of at least 60 years, free from CVD at baseline, followed up for 6 years. Data on psychosocial factors and CVD risk factors were obtained through validated questionnaires and laboratory measurements. A pain scale ranging from 0 (no pain) to 6 (worst pain) was created according to pain frequency, location, and intensity. Results: The cumulative incidence of CVD was 4.2% at 3 years and 7.7% at 5 years of follow-up. Compared to individuals without pain in the first 3 years (2012–2015), those with maintained scores of at least 2 showed a mean reduction of 3.57 (−5.77 to −1.37) METs-h/week in recreational physical activity, a 0.38-point (0.04–0.73) increase in psychological distress, and a 1.79 (1.03–3.11) higher odds of poor sleep. These associations held in the second follow-up period, when individuals with maintained pain also worsened their diet quality. A 1-point increase in the pain scale in 2012 was associated with a 1.21 (1.03–1.42) and 1.18 (0.97–1.44) increased CVD incidence in 2015 and 2017, respectively; none of the studied factors mediated this relationship. Conclusions: Older adults with chronic pain show important reductions in recreational physical activity and deterioration in mental health, sleep, and diet quality, which may well aggravate pain. Future studies should evaluate whether these factors mediate the increased risk of CVD observed in older adults with chronic pain.

Frailty complicates the care of individuals with dementia, increasing their vulnerability to adverse outcomes. This Personal View presents expert recommendations for managing frailty in individuals with dementia, aimed at health-care providers, particularly those in primary care. We conducted a rapid literature review followed by a consensus process involving 18 international experts on dementia and frailty. The experts identified key areas, including diagnosis of frailty, assessment of nutritional status and nutritional management, physical activity, prevention of falls, and polypharmacy management. The recommendations emphasise early identification of frailty and a comprehensive, interdisciplinary approach to care that aims to maintain the individual's daily functioning, quality of life, and independence. The recommendations highlight the importance of tailored interventions, regular monitoring, and the integration of psychosocial support into the therapeutic approach. These recommendations address a crucial gap in existing clinical guidelines, offering practical guidance for clinicians managing frailty in individuals with dementia.

Background: Malnutrition may increase the risk of frailty in individuals with musculoskeletal pain. However, this scenario has not been explored in detail. As such, the present study was conducted to examine the effects of malnutrition on the risk of incident and worsening frailty in community-dwelling older adults with musculoskeletal pain. Methods: Data from 895 community-dwelling older adults participating in the Toledo Study of Healthy Ageing who reported experiencing musculoskeletal pain during the month preceding data collection (mean age: 74.9 ± 5.6 years) were analyzed. Pain characteristics (i.e., intensity, locations, and treatment) were assessed based on self-reported information regarding the last month. Malnutrition was operationalized according to the GLIM criteria. Frailty status was assessed at baseline and at follow-up (~2.99 years), according to the Frailty Phenotype paradigm, operationalized through the Frailty Trait Scale 5. Associations between the variables were tested using logistic regression analyses adjusted for many covariates established a priori. Results: Malnutrition increased the risk of frailty (odds ratio [OR] = 4.41) and worsening of frailty status (OR = 6.25) in the participants who used ≥2 groups of painkillers in comparison to their non-undernourished peers. Conclusions: The findings of the present study indicate that malnutrition increases the risk of both developing and worsening frailty in older adults with musculoskeletal disorders. In particular, an increased risk of incident frailty and worsening frailty status was found in undernourished individuals using ≥2 analgesic drugs. Our results suggest that nutritional assessment should be included in the evaluation of old people living with musculoskeletal pain.

Objectives The objective is to assess the role of functional, clinical, and analytic parameters in predicting mortality in older patients hospitalized due to COVID-19. Design Cohort study with a mean follow-up of 12.8 days. Setting Public university hospital (Madrid, Spain). Participants 499 patients 80 and above consecutively admitted to a Spanish public university hospital between 4 March 2020 and 16 May 2020. Measurements Mortality was the main outcome. Data of sociodemographic variables (age, sex, living), comorbidities, polypharmacy, functional status, date of hospital admission and length of stay was recorded. Clinical symptoms, laboratory and X-ray findings were collected at time of admission. For multivariant analysis, logistic regressions were performed to identify risk factors for death. RESULTS: Mean age was 86.7±4.4 with 37% of death. Mortality was associated with male gender [odds ratio (OR) 1.50; 95% confidence interval (CI) 1.01–2.24], with a 5-points increase on Barthel Index [OR 1.01 (95%CI 1.00–1.02)], higher Charlson Index score [OR 1.13 (95%CI 1.02–1.26)] and comorbidities [OR 1.28 (95%CI 1.06–1.53)], hyperpolipharmacy [OR 2.00 (95%CI 1.04–3.82)], unilateral pneumonia [OR 1.83 (95%CI 1.01–3.30)], higher levels of C-reactive protein [OR 1.09 (95%CI 1.06–1.12)] and creatine [OR 1.48 (95%CI 1.15–1.89)]. Higher oxygen levels were a protective factor [OR 0.92 (95%CI 0.89–0.95)]. Conclusions Functional status, being male, a higher burden of comorbidities, hyperpolipharmacy, unilateral pneumonia and some laboratory parameters predict in-hospital mortality in this older population. The knowledge of these mortality risk factors should be used to improve the survival of older hospitalized patients.